Provider Demographics
NPI:1225844541
Name:PIERRE, STEVENSON
Entity type:Individual
Prefix:
First Name:STEVENSON
Middle Name:
Last Name:PIERRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28085 N SUPERIOR RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85143-3282
Mailing Address - Country:US
Mailing Address - Phone:602-301-8033
Mailing Address - Fax:
Practice Address - Street 1:28085 N SUPERIOR RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85143-3282
Practice Address - Country:US
Practice Address - Phone:602-301-8033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter